Palpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck.
You may:
Have an unpleasant awareness of your own heartbeat
Feel like your heart skipped or stopped beats
Your heart's rhythm may be normal or abnormal when you have palpitations.
Alternative Names
Heartbeat sensations; Irregular heartbeat; Palpitations; Heart pounding or racing
Considerations
Normally the heart beats 60 to 100 times per minute. The rate may drop below 60 beats per minute in people who exercise regularly or take medicines that slow the heart.
If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A heart rate slower than 60 is called bradycardia. An occasional extra heartbeat out of rhythm is known as extrasystole.
Palpitations are not serious most of the time. Sensations representing an abnormal heart rhythm (arrhythmia) may be more serious.
The following conditions make you more likely to have an abnormal heart rhythm:
Known heart disease at the time the palpitations begin
Once a serious cause has been ruled out by your health care provider, try not to pay close attention to heart palpitations. This may cause stress. However, contact your provider if you notice a sudden increase or a change in them.
When to Contact a Medical Professional
If you have never had heart palpitations before, see your provider.
Call 911 or the local emergency number if you have:
You often feel extra heartbeats (more than 6 per minute or coming in groups of 3 or more).
You have heart disease or risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure.
You have new or different heart palpitations.
Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).
You have related symptoms, such as chest pain, shortness of breath, feeling faint, or loss of consciousness.
What to Expect at Your Office Visit
Your provider will examine you and ask questions about your medical history and symptoms.
You may be asked:
Do you feel skipped or stopped beats?
Does your heart rate feel slow or fast when you have the palpitations?
Do you feel a racing, pounding, or fluttering?
Is there a regular or irregular pattern to the unusual heartbeat sensations?
Did the palpitations begin or end suddenly?
When do the palpitations occur? In response to reminders of a traumatic event? When you are lying down and resting? When you change your body position? When you feel emotional?
Do you have any other symptoms?
Do you consume stimulant drugs (such as amphetamine or cocaine), caffeine or excessive alcohol?
If you go to an emergency room, you will be connected to a heart monitor. However, most people with palpitations do not need to go to an emergency room for diagnosis and treatment.
If your provider finds you have an abnormal heart rhythm, other tests may be done. This may include:
Holter monitor for 24 hours, or another heart monitor for 2 weeks or longer
Curtis AB, Tomaselli GF. Approach to the patient with cardiac arrhythmias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 61.
Fang JC, O'Gara PT. History and physical examination: an evidence-based approach. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 13.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 49.
Review Date:
4/9/2024
Reviewed By:
Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
